Healthcare Provider Details

I. General information

NPI: 1124274410
Provider Name (Legal Business Name): VOLUNTEERS OF AMERICA CHESAPEAKE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2008
Last Update Date: 01/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1785 VERBENA STREET NW
WASHINGTON DC
20012
US

IV. Provider business mailing address

7505 GREENWAY CENTER DRIVE SUITE 201
GREENBELT MD
20770
US

V. Phone/Fax

Practice location:
  • Phone: 202-291-2241
  • Fax: 202-291-2283
Mailing address:
  • Phone: 301-389-3156
  • Fax: 301-389-3195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number038912700
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number038912700
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number038912700
License Number StateDC
# 4
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number38912700
License Number StateDC

VIII. Authorized Official

Name: MS. CONNIE C PRICE
Title or Position: DIRECTOR OPERATIONS
Credential: M.S.
Phone: 301-389-3166